Being injured in a car accident is unfortunate. However, you may be eligible to receive Accident Benefits (AB) coverage. Accident benefits cover a range of services, including medical treatment and rehabilitation, income replacement, death benefits, and attendant care. Across Canada, all provinces and territories offer variations in the amount of Accident Benefits available. Luckily for you, isure has the answers to some of the most commonly asked questions about AB coverage to help you understand how it works and what you need to know!
Are Accident Benefits mandatory in Ontario?
Yes. Accident Benefits are mandatory, and car insurance coverage includes them throughout Canada. An exception to this would be Newfoundland, where it is not compulsory!
Who is eligible for Accident Benefits?
Anyone involved in an accident with an insured vehicle is eligible for Accident Benefits. Even if you are the at-fault driver. Therefore, your spouse, children, grandchildren, parents, grandparents, siblings, certain other dependents, and guardians all qualify.
Who is not eligible for AB?
If the accident you are involved in happens as a result of an illegal act on your part, you can lose access to some benefits. Illegal acts include racing or driving without insurance. You may be disqualified from receiving income replacement payments as a result. However, your insurer may still cover some Accident Benefits.
Who pays for Accident Benefits coverage?
The at-fault vehicle pays for the accident benefits coverage. Being labelled at-fault means that you are responsible for the accident. This could mean failing to stop at a red light, not obeying traffic rules, or driving under the influence or while fatigued. Therefore, whether you are the driver, a passenger, a pedestrian, a cyclist, or even a family member who suffers losses because of an accident, you are eligible for benefits. Each party can file a claim with the insurance company of the at-fault vehicle.
Do I need to file an AB claim?
Yes, if you want to seek treatment for your injuries. Your claims adjuster can provide you with the necessary forms to submit. The Accident Benefits Application Package includes five forms. To have your medical expenses paid for or receive financial reimbursement for lost wages or damages, you must complete the forms and return them to your isure broker, who will then submit them to your insurer.
How long after a car accident can you make an AB claim?
Your insurer will only pay out on claims that are made within the defined timeframe on your policy. Depending on the insurer, the timeframe can range from a day to a few weeks. So, you should report accidents to your insurer within 24 hours, especially if you want your claim settlement as soon as possible. This will make sure that you are at the top of your insurer’s list. In some cases, your claim may take a while due to insurers being busy or backed up. If you submit a claim early, it will generally be avoided!
How long do Accident Benefits last?
Income replacement benefits are payable to you for up to 104 weeks (or two years) following your accident. To determine your level of injury and your possible recovery time, you will first receive an assessment.
Is it better to go through insurance or pay out-of-pocket?
You should file an insurance claim when you can’t afford to pay cash for damages or medical bills that your insurance policy will cover. On the other hand, you should pay out-of-pocket if the repairs or medical bills from an accident that you cause will cost less than your deductible.
What can I claim under the Medical and Rehabilitation benefit through AB?
The Medical and Rehabilitation benefit will cover all medical care requirements you may need, including the cost of rehabilitative therapy. The benefit applies only to healthcare costs not covered by a government or private healthcare plan. Let’s take a look at some of the items that your benefit may likely cover:
- Assistive devices (such as hearing aids, walkers, prostheses, and wheelchairs)
- Prescription and over-the-counter medications
- Ambulatory care
- Chiropractic care, physical or occupational therapy
- Vocational assessment and life skills training
- Family or career counselling
- Other medical expenses, such as replacement of damaged or lost prescription eyewear and dentures
What is a Section B claim?
Accident Benefits are sometimes called “Section B” benefits, depending on where you live. Section B benefits include no-fault accident benefits that are part of your automobile insurance policy. You are entitled to them, regardless of fault. For example, if you are a passenger in a vehicle that’s in an accident and you get hurt, your claim goes through the driver’s insurer.
What if I don’t have auto insurance? Who provides Accident Benefits coverage?
If you were a passenger in a vehicle or were struck (cyclist/pedestrian), the insurer of the driver would cover you, OR an insurer of any other automobile involved in the incident. Otherwise, the Motor Vehicle Accident Claims Fund would provide benefits.
What is Ontario’s Motor Vehicle Accident Claims Fund (MVACF)?
The MVACF is also known as the “payer of last resort” if you suffer an injury in an auto accident and there are no insurance policies to cover your claim. The MVACF is available to all Ontarians in the event of an accident within the province, provided that neither you nor the other driver has insurance. MVACF acts as a safety net for those injured in a motor vehicle accident without insurance coverage. This means it provides funds only when all other insurance options are unavailable. In many cases, this is used by victims of a hit-and-run accident, when the person deemed at fault is unable to be located. The MVACF will compensate up to $200,000 and will cover property damage, excluding costs.
What is LAT Accident Benefits Coverage?
The License Appeal Tribunal (LAT) is an independent agency that oversees your dispute with your insurance companies involving your Accident Benefits. If you have a dispute over a settlement with your insurer, it will be resolved by the Legal and Technical (LAT) department. The LAT will hear various types of appeals, mainly those related to automobile insurance disputes.
We hope our article helped you answer any questions you had regarding Accident Benefits! Remember, for any further questions related to Accident Benefits coverage, don’t hesitate to reach out to us at isure! Contact us or request a quote today!
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